When the St. David’s School of Nursing students from Texas State University signed up for two weeks of volunteer service at a third world country, they knew it wouldn’t be the same as providing healthcare in the United States.
What was not completely expected was that the experience would require them to use skills from their first days of nursing school and provide an opportunity to immerse themselves in the culture through the Nicaraguan people.
Stepping out of the comfort zone
Elizabeth Biggan, clinical assistant professor at St. David’s School of Nursing, said she prepares the students by talking to them about the poverty that they’ll see. She also shows them videos from previous trips, but she can’t fully prepare them for the clinics.
“Every bit of school that they go through at home is in a hospital where all equipment is readily available. All medications are readily available,” Biggan said. “It’s hard on the students to have a patient who needs medication, but they don’t have it and they have no way to get it. They really have to learn to adapt to the situation, but they also learn to get creative with their solutions.”
Experiencing those situations is what makes students’ nursing skills grow. In the Nicaragua clinics, they can’t rely on machines for reassurance.
Students manually check vital signs like blood pressure and temperature, something most haven’t done for four semesters. Biggan said this is where students step out of their comfort zones and learn to trust themselves.
The language barrier
The nursing students ranged from feeling confident with Spanish, to remembering some words from Spanish class in high school, to not knowing any Spanish at all. Some prepared for the clinics by studying the anatomical terms in Spanish. Others had to learn on the spot or rely on the translators, but the difficulty was part of the volunteering experience.
“The first house visit was mostly people looking at me and at one point even laughing, like ‘what is this girl saying?,’” said nursing student Bridgette Young. “By the end they were really understanding me and actually answering back without the translator.”
Massiel Acetuno, assistant team leader, said it’s difficult for the students to have social conversations when they’re not able to fully express themselves in the foreign language.
The students used their broken Spanish, hand gestures, facial expressions and voice pitch as they tried to make connections with the people.
“Volunteers try to do signs or play with the kids to bond with them,” Acetuno said. “Sometimes I feel helpless when I see them struggling with language but I like to see that even though they’re not speaking the same language, it’s like their souls connect.”
When people of different cultures meet
Acetuno, who is constantly introducing new people to her culture, said she enjoys it because it’s her chance to tell people why she’s so proud of being Nicaraguan. Acetuno describes Nicaraguans as people who welcome visitors and who receive them as family members.
“I love the most when we go to house visits and clinic days and they’re able to see by themselves that I wasn’t lying, that everything I said was true,” Acetuno said. “People still welcome you even though their houses are really poor, they always say to you ‘come in’ without any fear, without any doubt.”
The house visits to the communities are the first opportunity that the nursing students get to interact with Nicaraguans.
“They’re going to give you all the chairs for you to sit down. These people are so nice, so selfless,” nursing student Jessica Ramirez said. “They don’t have a lot to offer but they still keep offering.”
International Service Learning, the organization that plans the volunteering trips, identifies rural areas where healthcare is not easily available. This means that the conditions will be some that the students may not have seen before.
There were latrines, houses with dirt floors and without doors, wood cribs and unpaved roads. Despite the conditions, Nicaraguans displayed something else to their visitors.
“Happiness. They only show how grateful they are for the things that they have,” Acetuno said. “You may not see in their faces pain or sadness. You may not see depression, but most of the people that we see in the communities have huge problems. Sometimes they don’t have anything to eat that day.”
On the final day at the communities, the students handed out rice and beans, played games with the children and broke a piñata. It was a day to forget about nursing work and interact with the community they had been helping.
“I think the most difficult thing was giving the families rice and beans,” Ramirez said. “When we handed the parents food, that was real. We were giving them a means to survive for a week.”
Acetuno said that at the end of the trip it’s not just about helping people but also about taking the time to understand their situation, understand their history and why they are the way they are.
For nursing student Rachel Nading, leaving Nicaragua was the most difficult thing.
“I feel like it’s not enough. I feel like I could do more,” Nading said. “More in medical care, in treating people, just more.”